摘要
目的比较钢板内固定与髓内钉内固定治疗胫骨平台骨折不愈合并慢性感染的效果。方法胫骨平台骨折不愈合并慢性感染患者78例,按随机数字表法分为钢板组与髓内钉组,每组39例,两组患者术前均给予敏感抗生素抗感染治疗,钢板组采用锁定钢板内固定手术,髓内钉组采用扩髓髓内钉内固定术,比较两组手术时间、骨折愈合时间、术后并发症及骨痂生长评分、膝关节功能评分。结果髓内钉组的手术时间、骨折愈合时间短于钢板组(P<0.05),术后针道感染、关节伸直受限、马蹄足畸形、断针等并发症总发生率低于钢板组(P<0.05);术后3个月,两组骨痂生长评分、膝关节功能评分高于术前(P<0.05),且髓内钉组高于钢板组(P<0.05)。结论应用髓内钉内固定治疗胫骨平台骨折不愈合并慢性感染,能缩短手术时间、骨折愈合时间,减少并发症发生,更好地促进骨痂生长及改善膝关节功能。
Objective To compare the efficacy between intramedullary nail and plate internal fixation for treating fracture non-healing and chronic infection after surgery for tibial plateau fracture. Methods Seventy-eight patients with fracture non-healing and chronic infection after surgery for tibial plateau fracture were divided into plate group and intramedullary nail group using the random number table,with 39 patients in each group. All patients received anti-infection with sensitive antibiotics before surgery. The locking plate internal fixation was conducted in the plate group and the reamed intramedullary nail internal fixation in the intramedullary nail group. The operative time, time for facture healing, postoperative complications, callus growth score and knee function score were compared between the two groups. Results The operative time and time for fracture healing in the intramedullary nail group were shorter than those in the plate group（P 〈 0.05）. The total incidence rate of complications including postoperative pin tract infection ,joint extension limitation, clubfoot deformity and broken needle in the intramedullary nail group was lower than the rate in the plate group （ P 〈 0.05 ）. The callus growth score and knee function score of postoperative 3 months in both groups were higher than the preoperative scores, and the scores in the intramedullary nail group were higher than those in the plate group （ P 〈 0.05 ）. Conclusion Application of intramedullary nail internal fixation to fracture non-healing and chronic infection after surgery for tibial plateau fracture can shorten the operative time and time for fracture healing, reduce the incidence rate of complications, promote callus growth and improve knee function.
出处
《广西医学》
CAS
2016年第9期1225-1227,1231,共4页
Guangxi Medical Journal
基金
湖北十堰科技局课题(14Y50)
关键词
胫骨平台骨折
骨折不愈合
慢性感染
髓内钉
膝关节功能
内固定术
Tibial plateau fracture
Fracture non-healing
Chronic infection
Intramedullary nail
Knee function
Internal fixation
